IV Lymphoma

Patients with HIV infection are at a significantly increased risk of developing certain types of NHL compared to the general population. In the era of highly active antiretroviral therapy (HAART), a decline in lymphoma incidence has occurred, although, not to the same degree noted for other complications of HIV infection [1, 2]. As a result, lymphoma remains a common initial AIDS-defining illness in patients receiving HAART [2]. Risk factors for the development of NHL in this current era include lower CD4 count, higher HIV viral load, increased age and male gender [3]. The most recent CD4 count (as opposed to nadir count) is independently prognostic for development of lymphoma, suggesting a reduced risk of developing lymphoma if immune reconstitution with HAART occurs. Indeed, a recent prospective cohort study confirmed a reduced risk of NHL development with HAART exposure compared to single agent or no antiretroviral treatment [4].